Macroglobulinemia

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Abstract
The finding of a satisfactory method of management for primary macroglobulinemia, and the increasing realization, with time, that the disease was no longer rare, prompted this short exposition of its recognition and treatment. Common Symptoms A 52-year-old woman sought medical advice for failing vision. She had had mild, frequently recurring epistaxis for several years, and, more recently, dyspepsia and great fatigue. Severe, intractable anemia had been noted, and the patient had been transfused four times in the preceding three months. Visual disturbance, due to greatly distended retinal veins and associated retinal hemorrhages, while not as universally present as constant fatigue, is much more significant, as it is highly suggestive of symptomatic macroglobulinemia, especially in association with the characteristic fundal findings. Persistent oronasal bleeding and frequent weight loss are also suggestive. About a sixth of patients will have no symptoms when the macroglobulinemia is first detected (Fig 1). Usual Signs As

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